Cost of treatment set to Soar

Hartung DM, Bourdette DN, Ahmed SM, Whitham RH The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail? Neurology. 2015 Apr. pii: 10.1212/WNL.0000000000001608. [Epub ahead of print]

OBJECTIVE:To examine the pricing trajectories in the United States of disease-modifying therapies (DMT) for multiple sclerosis (MS) over the last 20 years and assess the influences on rising prices.
METHODS: We estimated the trend in annual drug costs for 9 DMTs using published drug pricing data from 1993 to 2013. We compared changes in DMT costs to general and prescription drug inflation during the same period. We also compared the cost trajectories for first-generation MS DMTs interferon (IFN)-β-1b, IFN-β-1a IM, and glatiramer acetate with contemporaneously approved biologic tumor necrosis factor (TNF) inhibitors.
RESULTS: First-generation DMTs, originally costing $8,000 to $11,000, now cost about $60,000 per year. Costs for these agents have increased annually at rates 5 to 7 times higher than prescription drug inflation. Newer DMTs commonly entered the market with a cost 25%-60% higher than existing DMTs. Significant increases in the cost trajectory of the first-generation DMTs occurred following the Food and Drug Administration approvals of IFN-β-1a SC (2002) and natalizumab (reintroduced 2006) and remained high following introduction of fingolimod (2010). Similar changes did not occur with TNF inhibitor biologics during these time intervals. DMT costs in the United States currently are 2 to 3 times higher than in other comparable countries.
CONCLUSIONS: MS DMT costs have accelerated at rates well beyond inflation and substantially above rates observed for drugs in a similar biologic class. There is an urgent need for clinicians, payers, and manufacturers in the United States to confront the soaring costs of DMTs.

The MS Market is currently about $20 billion and rising, Having realised that people with MS would pay a lot for drugs that were not very effective, with increasingly active drugs the cost soars ever higher.  In the USA it means increasing insurance costs and in the UK it means NICE first delay access to drugs as they haggle down the cost and probably NHS rationing will start as trusts seek to limit prescribing of drugs that will ultimately bankrupt them. The Risk Sharing Scheme results have allowed companies to hike their price.

The solution will have to wait until patents expire and chemicals arrive, but companies will do their utmost to ensure that they don't do that in a hurry. 

Alternatively we could develop a generic (or could we?) if there was a will and a pathway to do it.  Surprisingly there seems to be neither.

What happens when we have neuroprotective and remyelinating drugs what will the costs be then? Who will get there first academia or pharma...I know where my money is placed.

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